Archive for November, 2012

Okay I have to admit, I’m a little bit torn with this story. While I understand the reasoning behind it, I’m not sure that this is the best idea for young girls. The American Academy of Pediatrics has just recommended that pediatricians not only talk to their adolescent patients about emergency contraceptives like Plan B, but that they also offer them prescriptions to have on hand just in case they need it. Lylah M. Alphonse of Parenting talks about this controversial issue in “Should Pediatricians Give Kids Access to the Morning After Pill in Advance?”

The United States has a much higher rate of teen pregnancy than other industrialized countries, even though the teen pregnancy numbers have been going down for nearly two decades. With the rates still so high, the AAP believes that putting something like the morning-after pill in the hands of the teens who need it will help lessen that rate even more. Studies have found that the chances are much better for adolescents to use emergency contraception if they already had a prescription before the time they need it. I wonder if girls under the age of 17 can really comprehend what they are getting into without significant discussion about Plan B and sex in general.

While I believe that it is the parents’ responsibility to make sure that their children have education about sex and contraception, I do realize that this doesn’t always happen. But my initial concern about teens having easy access to Plan B is that it will either make their decision to have sex at a young age easier or make them less careful when they do. Seven studies showed, however, that having such a prescription does not increase the chances that a teen will have sex or lessen the chance that they will use protection against pregnancy. Plan B works best if it is used within a day of unprotected sex, although it can be taken up to 120 hours later. So it makes sense to have such a prescription available to those who may need it.

Offering Plan B prescriptions for girls under the age of 17 without telling their parents doesn’t sit right with me. I get it though. In an ideal world, girls would talk to their parents and ask for help if they had unprotected sex. Or better yet they would use protection because of their excellent sex education or even abstain altogether. It’s not an ideal world and girls make mistakes. Some even get taken advantage of against their will. These girls should have access to emergency help if they need it. I don’t know if a secret prescription for Plan B is the best bet, but it is something to help lower the teen pregnancy rate. There’s another question that arises with pediatricians prescribing Plan B. Will health insurance companies pay the cost of this prescription? And if not, it will most likely have to be the girls’ parents covering the cost.

One decision made by one health insurance company can really change the ways of the whole industry. Aetna has made the decision to cover the cost of weight loss drugs for some of its patients. This not only helps these patients, but the drug makers have seen an increase in stock prices because of this decision by Aetna. They will be selling more weight loss drugs because of Aetna’s patients, but it also is likely that other health insurers will follow Aetna’s lead and cover the drugs for their patients as well. This information comes from The Associated Press article “Weight loss drugmakers rise on Aetna Policy Update.”

Vivus Inc.’s Qsymia and Arena Pharmaceuticals Inc.’s Bleviq will now be covered by Aetna for patients who have a medical necessity. Aetna already covers Pfizer Inc.’s Didrex, GlaxoSmithKline plc’s Alli, and Roche’s Xenical. Aetna has the third largest enrollment of all health insurance companies in the United States. With 35% of the population being obese, Aetna has deemed this medical problem serious enough to cover drugs to help take care of it. Untreated, obesity leads to a host of other medical conditions that may cost insurers much more than these pills.

It’s not yet clear how many more people will be able to receive these drugs with Aetna’s policy update. Compare other health plans and it’s likely that the largest insurers will follow Aetna’s lead in covering these weight loss drugs. The FDA has been more willing to approve new weight loss drugs in the last year. A new drug is expected to be sent for approval next year. With the news of Aetna’s policy change, Vivus’ shares increased 13% and Arena Pharmaceuticals’ went up by 3.4%. Orexigen Therapeuticals Inc., who is developing obesity drug Contrave, saw a 6.9% increase in their share price. Maybe these obesity drugs can help stop the increasing rate of obesity in the United States.

Highmark, Pennsylvania’s largest health insurance company, is hoping to rival the hospital system of UPMC some day. They have been looking to merge with West Penn Allegheny since earlier this year, but the deal soured recently. According to Alex Nixon of The Pittsburgh-Tribune Review, leaders of both companies have been ordered by a judge to keep working on the deal, at least until the contract expires next May. In “Highmark, West Penn Allegheny Meet to Resurrect Merger,” Nixon says that the companies put out a joint statement saying that they will work once again on the $475 million deal.

There are multiple issues that the company leaders are working through, most which pertain to the finances of West Penn. West Penn is the second largest hospital system in the region, but is losing money and operating with a critical financial crisis. Their pensions are underfunded by $280 million, so Highmark suggested that the federal Pension Benefit Guaranty Corp. take them over. Bondholders are owed $750 million and Highmark is requesting that number be reduced to $400 million before the companies join forces. William Penn’s operations lost $112.5 million during the fiscal year ending this June 30.

Highmark made these financial requests during an injunction hearing. A judge allowed Highmark an injunction preventing West Penn from talking with other interested parties until May. West Penn said that they had the right to talk with others because Highmark wanted them to go through bankruptcy because of the bond and pension debt. They believed that Highmark had broken their contract with that request. But now the two sides will be working together again and trying to secure a formal deal for West Penn’s five hospital health care system. Acquiring the system is part of a $1 billion plan Highmark has to compete with UPMC.

One thing is abundantly clear after the Presidential election yesterday; Americans are divided politically. Whether you are in the small majority of Americans happy with President Obama’s re-election or one of those who were hoping for a Romney win, you will likely be affected by changes in health insurance. This win by Obama just about cements his health care reform changes, some of which have already taken effect. Americans with pre-existing conditions can no longer be denied health insurance coverage because of their health problems. Also, many more young adults are insured now because they can stay on their parents’ plans until age 26.

In the CNN Money article, “Obama’s re-election secures health care reform,” Emily Jane Fox says that while most of the changes will take place in 2014, some insurance changes will happen next year as well. Even without the majority of the changes being in effect, the number of uninsured Americans decreased this year for the first time in four years. Americans who are 19 to 25 and often uninsured are happy about the changes as well because 3.1 million more of them now have insurance. The individual insurance mandate requiring most Americans to carry insurance doesn’t go into effect until 2014, but the following changes will happen next year.

In order to help pay for federal subsidies that lower and middle class Americans will receive to help pay for their health insurance, two Medicare taxes are going to start in 2013. There will be a new surtax on wage income for people making more than $200,000 a year or couples making more than $250,000 a year. Investors will also start getting charged a 3.8% tax on part of their capital gains and dividends. The surtax will affect around 2.4% of Americans, or 4 million people at first. That number is estimated to be 8.3 million, or 4.6% of households by 2022. A $2,500 limit will be imposed on workers’ tax-deductible contributions to flexible savings accounts. Employers will be required to offer health insurance when they have more than 50 employees who work for them full-time. This last item will be required by 2014 and fines will apply if it isn’t adhered to.

Whether you supported President Obama or not, his health care changes are here to stay. Some Americans will see very positive outcomes from their health insurance changing, while others are unhappy about the added taxes and the required health insurance coverage. We’ll continue to follow this story as the mandates take effect.